Group Interest Form

* Name of Group:

* Type of Group:

* Size of Group:

(estimated number of participants)

* First Name:

* Last Name:

* Title:

* Email:

* Phone:

(xxx-xxx-xxxx)

Fax:

(xxx-xxx-xxxx)

* Address 1:

Address 2:

* City:

* State:

* Zip:

Availability:

(estimates only)

Comments:

Newsletter:

Yes, I would like to receive occasional updates about how The Salvation Army is helping people in our community at the email address above.

NOTES: